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WillBrink
08-25-2005, 04:40 PM
WASHINGTON (Reuters) -- The death of San Francisco 49ers lineman Thomas
Herrion after a preseason game comes as little surprise because of his
size, obesity experts said Tuesday.

Just last March the Journal of the American Medical Association published a
report cautioning about the high rate of obesity among U.S. National
Football League players.

Despite careful medical exams and efforts to keep the players physically
fit, it is very difficult for someone who weighs so much to be completely
healthy, said Dr. Xavier Pi-Sunyer, an obesity expert at Columbia
University in New York.

Herrion, 23, collapsed without warning Saturday and the 6-foot-3, 330-pound
offensive lineman was pronounced dead at a Denver hospital. Officials are
awaiting toxicology results after an autopsy failed to reveal the cause of
Herrion's death.

"A sudden death like that in a 23-year-old with no evidence of a stroke
would suggest that he had an arrhythmia," Pi-Sunyer said in a telephone
interview.

"We do know that he weighed 330 pounds."

That would give Herrion a body mass index of more than 41 -- well into the
area considered morbidly obese and thus putting him at high risk of health
problems.

Certain athletes with high muscle mass can safely veer into BMIs of between
25 and 30, which would be considered overweight for the average person, but
a BMI of 40 or higher cannot be considered anything but risky, experts say.

In March, Joyce Harp of the University of North Carolina at Chapel Hill
found that more than a quarter of NFL players had a body mass index that
qualified as morbidly obese.

The NFL claims Harp's study was flawed.

"The study uses BMI, which does not distinguish between fat and muscle,"
NFL spokesman Greg Aiello said on Tuesday. "Any study that is done without
taking into account body fat percentage is misleading."

Harp said it was unlikely the extra weight was due to muscle mass alone.

"The high prevalence of obesity in this group warrants further
investigation to determine the short- and long-term health consequences of
excessive weight in professional as well as amateur athletics," she wrote
in her report, published in the Journal of the American Medical
Association.

Pi-Sunyer agreed.

"When you get these huge lineman who are weighing 350 pounds ... then the
chances are that they have more muscle but they also have significantly
more fat," he said.

"We do know that excess fat brings with it certain risks. Included in these
risks are primarily diabetes, high blood pressure and heart disease."

Also, he said, people with excess fat tend to have higher free fatty acids
circulating in the blood.

"There has been some data to suggest that higher circulating free fatty
acids could be a risk factor for increased cardiac arrhythmia," Pi-Sunyer
said.

"He had just finished playing a vigorous game of football. Possibly, free
fatty acid levels, given his weight and excess fatness, might have been
elevated ever further after that."

erp7e
08-25-2005, 07:20 PM
Other than the fact that the BMI means jack unless you're talking about sedentary people, certainly not NFL linemen who are in better shape than 90% of skinny people who are non-athletes...let me point out Pi-Sunyer's flaws in logic at the end of the article.

1) People with excess fat tend to have higher levels of FFA. Yes. But people with high BMI do not necessarily have them. He is linking BMI, his only hard piece of data, with arrhythmias.

2) None of the studies looking at mortality and morbidity of high-BMI people used exclusively NFL offensive linemen as their subject base. How can you apply the data of fat, couch-potato, Krispy-Kreme eating sedentary people to offensive linemen who are physically conditioning 40+ hours a week? Your subjects are not applicable based on your data.

3) The study he is refering to showed that higher circulating free fatty acids are associated with increased cardiac arrhythmia. He's neglecting confounding factors that if taken out, show no association. The confounding variable is that these same people had propensity for coronary disease and infarct, leading to arrhythmia. If there is no evidence of myocardial infarction in this guy, the mere prescence of high circulating FFA has no etiologic potential based on what we currently know. In layman's terms, if you infarct some heart muscle (OK, "heart attack"), it can cause changes in conduction patterns and muscular contraction in the heart (or lack thereof in the appropriate places). But merely having high FFA levels in the blood, in the absence of ischemia or injury, does not directly impact cardiac conduction. There is no evidence for this.

The problem is these 'obesity experts' are indeed experts when working with fat ass sedentary people who think walking to the freezer to get more ice cream is 'physical activity.' They do not routinely work with athletes.

Just last week we had a lecture on obesity before our clinic. I got into a 'discussion' with the lecturer, who stated that the best thing to do for these people from a dietary standpoint (well, the second-best thing, after #1: eliminating soda, and I agree wholeheartedly) was to decrease fat intake. My first thought was, what about omega-3's and mono's, these are the very substances that can protect these people.

But the lecturer wisely pointed out to me that none of these people touch fish, olive oil, etc. When they eat fat, it's nearly always the trans fat of fast food or convenience food. Fat is more calorically dense, so this is a way to help them lose some of their 400+ pounds of lard.

The problem here wasn't whether the lecturer or I was right, it was that we were thinking of entirely different populations: she, fatasses, me, athletes. So we were both right for our respective populations.

Just as I have a limited grasp on what to do with completely unmotivated sedentary 400+ lb. people, I think these obesity experts have a limited grasp on weight loss and body composition for athletes.

If the guy had a heart attack, fine, that killed him. His BMI did not.

WillBrink
08-25-2005, 07:40 PM
Other than the fact that the BMI means jack shit unless you're talking about sedentary people, certainly not NFL linemen who are in better shape than 90% of skinny people who are non-athletes...let me point out Pi-Sunyer's flaws in logic at the end of the article.

1) People with excess fat tend to have higher levels of FFA. Yes. But people with high BMI do not necessarily have them. He is linking BMI, his only hard piece of data, with arrhythmias.

2) None of the studies looking at mortality and morbidity of high-BMI people used exclusively NFL offensive linemen as their subject base. How can you apply the data of fat, couch-potato, Krispy-Kreme eating sedentary people to offensive linemen who are physically conditioning 40+ hours a week? Your subjects are not applicable based on your data.

3) The study he is refering to showed that higher circulating free fatty acids are associated with increased cardiac arrhythmia. He's neglecting confounding factors that if taken out, show no association. The confounding variable is that these same people had propensity for coronary disease and infarct, leading to arrhythmia. If there is no evidence of myocardial infarction in this guy, the mere prescence of high circulating FFA has no etiologic potential based on what we currently know. In layman's terms, if you infarct some heart muscle (OK, "heart attack"), it can cause changes in conduction patterns and muscular contraction in the heart (or lack thereof in the appropriate places). But merely having high FFA levels in the blood, in the absence of ischemia or injury, does not directly impact cardiac conduction. There is no evidence for this.

The problem is these 'obesity experts' are indeed experts when working with fat ass sedentary people who think walking to the freezer to get more ice cream is 'physical activity.' They do not routinely work with athletes.

Just last week we had a lecture on obesity before our clinic. I got into a 'discussion' with the lecturer, who stated that the best thing to do for these people from a dietary standpoint (well, the second-best thing, after #1: eliminating soda, and I agree wholeheartedly) was to decrease fat intake. My first thought was, what about omega-3's and mono's, these are the very substances that can protect these people.

But the lecturer wisely pointed out to me that none of these people touch fish, olive oil, etc. When they eat fat, it's nearly always the trans fat of fast food or convenience food. Fat is more calorically dense, so this is a way to help them lose some of their 400+ pounds of lard.

The problem here wasn't whether the lecturer or I was right, it was that we were thinking of entirely different populations: she, fatasses, me, athletes. So we were both right for our respective populations.

Just as I have a limited grasp on what to do with completely unmotivated sedentary 400+ lb. people, I think these obesity experts have a limited grasp on weight loss and body composition for athletes.

If the guy had a heart attack, fine, that killed him. His BMI did not.

I agree with all of the above of course and know how little worth BMI has with athletes. Of course the pro bbers I know throw the BMI totally out of whack, not to mention my own high BMI. Having said that. I will say that many of the front line men are plain old fat, appearing to have 20-25% Bf and big guts, and it would be much more telling and useful to see BF% tested. My ex father in law tested the Pats players years ago (He was the director for the Natick Army labs whre they did extensive metabolic testing) and he mentioned how fat some of the Pats players were. Makes sense. I know other coaches and trainers in pro football, and it's predictable what they say about some of the big line men vs other positions. So far, it seems 99% of the time one of these guys drops dead, it's some massive linemen who carries much LBM and a good deal of BF. There is some theories that high BMI's, above 30, will increase mortality regardless of what it's made of, but I would need to see real data before I believed it.

erp7e
08-25-2005, 11:34 PM
Certainly some of the lineman are indeed fat, however, as you mention, a high BMI does not automatically 'convict.' Also, I think the body comp of the NFL lineman has changed considerably in the past 20 years as good training, nutrition, and AHEM supplements have become more widespread. The most reliable way to test bodyfat percentage is autopsy, so if they wanted to do that in this case they could.

Also - there must be other factors. How about someone with a bodyfat of 20% who is in fantastic shape across all energy systems? Vs. someone with a bf of 6% who would tire out climbing a flight of stairs? Who knows? I sure don't. This type of stuff just hasn't been studied. In the context of recommending weight training to the general population, the question of increased BMI potentially comes up. I think it would be worthwhile to look at morbidity and mortality related to:

1) Bodyfat percentage
2) Lean body mass
3) Some metabolic capacity parameter like VO2max, lactate threshold, etc., in other words, regardless of weight or bodyfat level or composition, how does athletic capacity correlate with M&M? I would venture to guess that regardless of bf%, if you are in fantastic shape your cardiopulmonary systems can withstand more stress and have a higher threshold before ischemia or infarct.

Agent86
08-26-2005, 06:13 AM
Another thing to consider is the timing, he is not the first NFL linemen to die during training camp. They go straight from an off-season of relaxing and limited workouts to 2-a-days under the summer sun along with possible dehydration.

Another thing is pressure. This man was already cut once by the Dallas Cowboys, and must have been under enormous pressure to make the team. So its not out of the question that if the coach tells him that he needs to loose some weight, he might take drastic measures such as not drinking much water or not eating enough food.

My gut feeling tells me it had more to do with how he was taking care of his body during training camp then his life long physical condition.

alwaysimprove
08-26-2005, 02:16 PM
Another thing to consider is the timing, he is not the first NFL linemen to die during training camp. They go straight from an off-season of relaxing and limited workouts to 2-a-days under the summer sun along with possible dehydration.

Another thing is pressure. This man was already cut once by the Dallas Cowboys, and must have been under enormous pressure to make the team. So its not out of the question that if the coach tells him that he needs to loose some weight, he might take drastic measures such as not drinking much water or not eating enough food.

My gut feeling tells me it had more to do with how he was taking care of his body during training camp then his life long physical condition.

This whole thing show how much you know about professional athletes...
No one in pro sports takes the "off-season" off to relax, and an NFL coach doesn't tell his linemen to lose weight.
They come into camp in great "shape" so they can beat out the next best guy in camp, especially someone who is trying to crack the line-up...
I know in the "good old days" guys came into camp to get in shape for the season but times have changed my friend, times have changed.

WillBrink
08-26-2005, 03:31 PM
Certainly some of the lineman are indeed fat, however, as you mention, a high BMI does not automatically 'convict.' Also, I think the body comp of the NFL lineman has changed considerably in the past 20 years as good training, nutrition, and AHEM supplements have become more widespread. The most reliable way to test bodyfat percentage is autopsy, so if they wanted to do that in this case they could.

Also - there must be other factors. How about someone with a bodyfat of 20% who is in fantastic shape across all energy systems? Vs. someone with a bf of 6% who would tire out climbing a flight of stairs? Who knows? I sure don't. This type of stuff just hasn't been studied. In the context of recommending weight training to the general population, the question of increased BMI potentially comes up. I think it would be worthwhile to look at morbidity and mortality related to:

1) Bodyfat percentage
2) Lean body mass
3) Some metabolic capacity parameter like VO2max, lactate threshold, etc., in other words, regardless of weight or bodyfat level or composition, how does athletic capacity correlate with M&M? I would venture to guess that regardless of bf%, if you are in fantastic shape your cardiopulmonary systems can withstand more stress and have a higher threshold before ischemia or infarct.

I agree there is a real lack of data to come to any solid conclusions, and using BMI and correlating athletes to the general publics is of course worthless. I also think there are many variables simply not understood and or appreciated. For example, I have a theory that the regular trauma football players are exposed to might cause vascular injury. I am sure several mechanisms for that could be figured out. One that comes to mind is the huge increase in oxidative stress from a big dump of iron into the system from large bruised areas which football players live with for years on end. No doubt, football players on average have far less BF and more LBM then they used to.

Agent86
08-26-2005, 10:43 PM
This whole thing show how much you know about professional athletes...

an NFL coach doesn't tell his linemen to lose weight.


I see you havent met Mr. Bill Parcels, one time in traning camp he asked his linemen how much you weigh? The guy awnsered back 250. Parcels walks to over to the scale and it read 280, he says thats amazing you gained 30 lbs on the walk over here.

I listin to about 50% of his press confrences and his ALWAYS on his linemen about thier weight.

pizzaman
08-27-2005, 01:04 AM
an NFL coach doesn't tell his linemen to lose weight.


Maybe this qualifies as being part of the "old days", but back in the 90's the Forty-Niners coaches were always on Bubba Paris' case to lose weight, but he always came to training camp way over target.

erp7e
08-27-2005, 08:20 PM
In this particular case, however, this guy was determined to make the 49ers and went back to his college for the spring/summer to get in shape prior to training camp. According to one of his former coaches, whom he roomed with just months ago while he was training on campus, this guy was in the best shape of his life. I still haven't heard any rule/out of hypertrophic cardiomyopathy or anything like that, which would have zero to do with BMI.

ray2nite
08-28-2005, 07:55 PM
My guess is that someone will say he was taking creatine (or something similar), that is still legal, and then congress will put a ban on it.

erp7e
08-28-2005, 09:26 PM
Sadly, I'm afraid you're right. Our government has a pathologic obsession with affixing blame on someone, anyone (justly or not), following a tragedy as a way of pacifying the public.

plague
09-13-2005, 03:09 AM
I think alot of football players are just plain old fat AND out of shape. I watched a program years ago on how they are expected to be big so they eat and they eat and they eat. Football is not a physically demanding sport other than the tackling and body impacts. They run a play, it lasts seconds, then they have a few minutes... or more... rest....not something you really have to be in shape for compared to say a mixed martial artist, boxer, or other active dynamic sports.

erp7e
09-13-2005, 09:28 PM
Football is definitely demanding from a conditioning standpoint. By the end of four quarters, you are whipped. Although I'll give you that it's not up there with combat sports.

There definitely are some fat football players but if you see how some of these OL/DL perform at the combine there definitely are some who are in shape as well.